Request for Mayor/City Council Member at a Special Event

PLEASE NOTE: Completion of this form does not confirm the attendance of the Mayor or any Member of City Council at your event.

Once your invitation has been received, you will be contacted as soon as possible.

POINT OF CONTACT: Sandy Madison, 757-382-6151, smadison@cityofchesapeake.net

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Name of Event Date Start and End Time Place/Address of Event Hosting Organization or Group Point of Contact Name Point of Contact Email Address  Enter a valid email address. Example: name@company.com Point of Contact Cell Phone Number  Enter a valid phone number. Example: 123-456-7890 Name of Requested Public Official Approximate Number of Attendees Welcome Address? YesNo Keynote Address? YesNo Length of Time for Remarks, if Applicable Start Time for Remarks, if Applicable Required Arrival Time for Mayor/Council Members Point of Contact Name and Cell Number at the Event, if Different from Above Name of Leadership of Organization who will be in Attendance And Additional Information, including History of the Organization or Group.